Background Health systems harbor lucrative data that can be targeted for illegal access, thus posing a serious privacy breach. In addition, patients could lose their lives or suffer permanent and irreversible harm due to such unauthorized access to health care data used in treatment. To ensure patient safety, the health care sector must integrate cybersecurity into its operations. Additionally, the health care industry must collaborate to tackle cybercrime and prevent unauthorized access to patient data. With the rapid transition from paper-based health records to electronic health records (EHRs), it is important to study, identify, and address the challenges that confront EHRs to protect patient confidentiality. Aim The main goal of this research was to create a clear picture of the role of EHRs in the health care system of Saudi Arabia regarding patient confidentiality. This work focused on the privacy and confidentiality challenges encountered in adopting EHRs in the health care system, and the advantages of using EHRs in terms of protecting patient confidentiality. Methods This project utilized a systematic literature review approach, and the methodology involved a careful critique of 11 recent articles. Results The confidentiality and privacy of patient data and information must be ensured, because the health care sector in Saudi Arabia is flawed with several security risks that may corrupt the integrity of patient data. The health care system is facing many cybercrimes whereby hackers can gain access to confidential data and patient information. Internal factors such as inexperienced medical personnel have also necessitated EHRs in Saudi Arabia. Health care workers who lack the appropriate skills in handling EHRs may cause breaches of patient data, which in turn may compromise the health and safety of the patients. Conclusion Confidentiality and privacy are critical components of a reliable EHR system. EHR confidentiality has a significant impact on maintaining patient safety and security, thus enhancing patient care in Saudi Arabia. Additionally, challenges such as hackers and data breaches have slowed the adoption process among health care companies in Saudi Arabia.